Acid-base and bio-energetics during balanced versus unbalanced normovolaemic haemodilution

Morgan, TJ, Venkatesh, B, Beindorf, A, Andrew, I and Hall, J (2007) Acid-base and bio-energetics during balanced versus unbalanced normovolaemic haemodilution. Anaesthesia And Intensive Care, 35 2: 173-179.

Author Morgan, TJ
Venkatesh, B
Beindorf, A
Andrew, I
Hall, J
Title Acid-base and bio-energetics during balanced versus unbalanced normovolaemic haemodilution
Journal name Anaesthesia And Intensive Care  (ERA 2012 Listed)    (ERA 2010 Rank C)   Check publisher's open access policy
Publication date 2007
Sub-type Article
Volume number 35
Issue number 2
ISSN 0310-057X
Start page 173
End page 179
Total pages 7
Place of publication Edgecliff
Publisher Australian Soc Anaesthetists
Collection year 2008
Language eng
Subject C1
Abstract Fluids balanced to avoid acid-base disturbances may be preferable to saline, which causes metabolic acidosis in high volume. We evaluated acid-base and bio-energetic effects of haemodilution with a crystalloid balanced on physical chemical principles, versus crystalloids causing metabolic acidosis or metabolic alkalosis. Anaesthetised, mechanically ventilated Sprague-Dawley rats (n=32, allocated to four groups) underwent six exchanges of 9 ml crystalloids for 3 ml/blood. Exchange was with one of three crystalloids with strong ion difference (SID) values of 0, 24 (balanced) and 40 mEq/l. Controls did not undergo haemodilution. Mean haemoglobin concentration fell 11 to approximately 50 g/l after haemodilution. With SID 24 mEq/l fluid, metabolic acid-base remained unchanged. Dilution with SID 0 mEq/l and 40 mEq/l fluids caused a progressive metabolic acidosis and alkalosis respectively. Standard base excess (SBE) and haemoglobin concentration were directly con-elated in the SID 0 mEq/l group (R-2 = 0.61), indirectly correlated in the SBE 40 mEq/1 group (R-2 = 0.48) and showed no correlation in the SID 24 mEq/l group (R-2=0.003). There were no significant differences between final ileal values of CO2 gap, nucleotides concentration, energy charge, or luminal lactate concentration. SID 40 mEq/l crystalloid dilution caused a significant rise in subcutaneous lactate. In this group mean kidney ATP concentration was significantly less than controls and renal energy charge significantly lower than SID 0 mEq/l and control groups. We conclude that a crystalloid SID of 24 mEq/l provides balanced haemodilution. Bio-eneigetic perturbations with higher SID haemodilution may be more severe and need further investigation.
Keyword Anesthesiology
Critical Care Medicine
acid-base
balanced crystalloid
bio-energetics
haemodilution
strong ion difference
Lactated Ringers Solution
Metabolic-acidosis
Hyperchloremic Acidosis
Cardiopulmonary Bypass
Nitric-oxide
Respiratory Alkalosis
Crystalloid Solutions
Fluid Resuscitation
Experimental Sepsis
0.9-percent Saline
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article
Collection: School of Medicine Publications
 
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Created: Mon, 18 Feb 2008, 17:04:14 EST